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Constipation

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Constipation

Constipation is a common condition that can affect people of all ages.

Typically, constipation means that you are not passing stools (poo) regularly or that you are unable to fully empty your bowel. It can cause your stools to be lumpy, hard and unusually small or large.

Constipation can be a long-term (chronic) condition that can cause significant discomfort and pain and reduce the quality of life, however it usually only lasts for a short time and can usually be treated at home with easy changes to your diet and lifestyle.

Symptoms

You are likely to have constipation if:

  • You or your child haven’t had a bowel movement at least three times a week
  • Hard or lumpy stools
  • Unusually large or small stools
  • You find it difficult to push out a bowel movement and have to strain
  • You are unable to completely evacuate your bowels when you have a movement
  • Pain when evacuating your bowels

However, if you are breastfeeding it is not unusual for you to go a week without having a bowel movement.

Moderate/Chronic symptoms

  • If you have at least two of the common symptoms of constipation for more than three months
  • You are not improving with treatment
  • You may also have a stomach ache, feel bloated or sick
  • Loss of appetite

 

Symptoms in babies and toddlers

  • Lack of energy
  • Being irritable, unhappy or angry
  • Soiling their clothes when they have already been potty trained (this can be evidence that a hardened piece of stool has become stuck at the end of their gut (rectum)
  • Foul-smelling stools and wind
  • Generally feeling unwell

When to see an expert at Ahmeys?

If the simple lifestyle and diet changes aren’t helping, we advise that you call Ahmeys to speak to or book an appointment with one of our experts.

If you think your child may have constipation, we especially recommend that you talk to one of our experts.

If you or your child experience any of the following symptoms, call Ahmeys to speak to an expert:

  • You are not improving with treatment
  • You are frequently constipated and it lasts for a long period of time
  • You are bloated and it lasts for a long period of time
  • You have blood in your stool
  • You have unexpectedly lost weight
  • Your child has not grown or gained weight
  • You feel very tired all the time

Causes

Constipation in adults has many potential causes, the most common are:

  • Not having enough fibre (vegetables, fruit and cereals)
  • Not drinking enough liquid
  • Not being active or exercising enough
  • Ignoring the urge to go to the toilet and delaying going to the toilet
  • Stress, anxiety and depression
  • Changing your daily routine or diet
  • A side effect of your medication
  • Constipation is also common during pregnancy and for six weeks after giving birth

In addition to the common causes above, there are causes that are specific to babies and toddlers.

For both adults and children sometimes there can be no obvious reason why a person has constipation, but in babies and young children it usually can happen when:

  • Your child starts taking the formula and or processed foods as a baby
  • Is being potty trained as a toddler
  • Has just started school (as this is a significant change in routine and can cause anxiety about using the toilet)
  • Overfeeding (including giving babies too much milk)
  • General fear or anxiety about using the toilet
  • Poor potty training (when the toddler is regularly interrupted or feels pressured)

Possible complications

Most people with constipation rarely experience complications. However, people with long-term or chronic constipation can develop:

  • Rectal bleeding
  • Haemorrhoids (piles – swollen blood vessels that form in the lower rectum and anus)
  • Itching, pain and swelling of the anus and surrounding area
  • Faecal impaction (dried, hard stools collect in your rectum and anus)

Diagnosis

If you are able to recognise from the list of symptoms that you have constipation, you can usually treat it at home by making sure you drink enough fluids, exercise and have enough fibre in your diet.

If you are concerned that your symptoms are severe or have lasted for a long time, call Ahmeys to book an appointment with one of our experts to discuss your symptoms and potential treatments. An expert at Ahmeys will review your symptoms and perform a physical exam and examine your abdomen to confirm the diagnosis.

Treatment

Once one of our experts has assessed you, they will discuss treatment options with you. Treatments may include:

  • Oral laxatives (could be bulk-forming, osmotic or stimulant and are all a type of medicine that helps you pass stools)

If your body does not respond to different types of laxative and or if you have faecal impaction or overflow diarrhoea (where loose stools leak around the obstruction) you may be prescribed one of the treatments below:

  • Suppository (medication inserted into your anus that gradually dissolves at body temperature and is absorbed into your bloodstream)
  • Enema (medication, such as Docusate and sodium citrate, in a liquid form, is injected through your anus into your large bowel)
  • Water irrigation
  • Manual removal by inserting a gloved finger into the rectum to remove the blockage

How to manage your symptoms?

  • Avoid alcohol
  • Drink plenty of fluids
  • Increase the fibre in your diet (add some wheat bran, linseed or oats to your diet and try to eat at least 18-30g of fibre per day)
  • Try walking or running daily
  • A brisk (three miles per hour) ten-minute walk per day should help regulate your bowel movements and is beneficial for your overall health
  • If you are not able to walk but can do other forms of non-weight bearing exercise, you could try swimming
  • If your constipation is caused by pregnancy, keep up your daily physical activity for as long as you feel comfortable
  • Give yourself a regular time, place and privacy to use the toilet
  • Try not to ignore the urge to go to the toilet
  • Try resting your feet on a low stool while using the toilet and if possible raise your knees above your hips
  • If constipation is causing pain and discomfort, you may want to take either paracetamol, aspirin or ibuprofen. Children under 16 should not take aspirin
  • If your medication could be causing constipation, talk to an expert at Ahmeys who may be able to suggest an alternate treatment
  • Call Ahmeys to speak to an expert and discuss laxatives that can help, like Fybogel

How to manage your child’s symptoms?

  • Increase the fibre in their diet and encourage them to eat fruit. This can be puréed if it is easier for them to eat. The best fruits for constipation are: apples, pears, grapes and strawberries
  • Make sure they are drinking enough liquids
  • Ensure they are getting the recommended amount of exercise for their age
  • Give your baby extra water between their normal feeds if they haven’t started to eat solid food yet, but do not add extra water to the mixture if you are using formula
  • Try gently moving your baby’s legs in a bicycling motion and or carefully massage their tummy to help stimulate their bowels
  • If your child is potty training, give them plenty of time to use the toilet and reward and encourage them for using it
Faheem Ahmed

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Providing NHS services

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158 Oxford Road
Cowley, Oxford, OX4 2LA
Contact us at:
info@ahmeysclinic.com
01865 689 149

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